Endoscopic management of biliary ascariasis.

Cholangitis and pancreatitis have resulted from migration of Ascaris lumbricoides up the biliary tree. We report our experience with the endoscopic management of 11 patients who presented with cholangitis and pancreatitis. Successful endoscopic worm extraction with or without sphincterotomy was achieved for worms located in the biliary tree but endoscopic worm extraction from the pancreas was technically difficult. Anthelminthic therapy is indicated to eradicate the gut infestation and prevent recurrent disease.